Ocular Surface Metrics in Blepharospasm Patients After Treatment With Botulinum Toxin Injections

Area of Science:

• Ophthalmology
• Neurology

Background:

• Blepharospasm is a focal dystonia causing involuntary eyelid closure.
• Ocular surface dysfunction and dry eye symptoms are common in blepharospasm patients.
• Botulinum toxin is a primary treatment for blepharospasm, but its effect on the ocular surface is not fully understood.

Purpose of the Study:

• To assess the effect of botulinum toxin (onabotulinumtoxinA) on ocular surface parameters in patients with blepharospasm.
• To evaluate changes in tear meniscus area, tear break-up time, and dry eye symptoms after treatment.

Main Methods:

• A prospective study involving 20 blepharospasm patients treated with onabotulinumtoxinA.
• Eyelid movements were recorded using a smartphone and custom software.
• Tear meniscus area was assessed via optical coherence tomography.
• Tear break-up time and Ocular Surface Disease Index (OSDI) were evaluated before and 15 days after treatment.

Main Results:

• Botulinum toxin significantly reduced eyelid spasm frequency (23.18±12.85 to 9.29±6.87 movements/min).
• Significant improvements were observed in tear meniscus area (p=0.01) and tear break-up time (p=0.03).
• A significant reduction in OSDI scores indicated improvement in dry eye symptoms (p<0.0001).

Conclusions:

• Botulinum toxin treatment for blepharospasm leads to objective and subjective improvements in ocular surface parameters.
• The findings suggest botulinum toxin influences the lacrimal pump mechanism.
• Treatment effectively alleviates dry eye symptoms in blepharospasm patients.